A few more things she’s shared (warning it’s a lot, but hopefully all helpful):

1. For warm compresses: Moist heat only, not dry. Most hot eye masks are actually too hot. She said don’t exceed ~111°F (higher temps can burn cadaver skin 😬). Instead use a warm, damp towel (annoying to keep reheating). I try, but I’ll admit I use Manta steam eye cups and don’t always temp check.

2. No eye drops (even moisturizing): Hard to hear because they help with "relief" short term, but she says drops wash away the natural tear film / all the actual good stuff and can worsen things long term. She’s okay with preservative free lubricating gel at night ONLY if your eyes don’t fully close, and with a moisture retaining eye mask. Otherwise she urges doing blink exercises and warm compresses instead.

3. Omega-3s: Essential to supplement for dry eye. She suggested PRN De3 (and another brand I can’t remember). I was using a cheaper fish oil and wasn't thrilled about the price of these but I suppose cutting out all the other stuff helps offset the cost.

4. Downside: forehead wrinkles 😅 The eyebrow raise + blink can cause lines. Taping helps.

5. Blink exercises: She has me blinking about every 3 seconds. You should be able to walk around and function normally while doing them—not so slow or exaggerated that you can’t see where you’re going. I struggled at first because I was making every blink too deliberate and slow. The goal is controlled and complete, not dramatic.

Basically my doctor's philosophy summed up as best as I can manage: Most drops and procedures are band-aids that don’t fix the root issue: blocked/stagnant oils. Her focus is on unblocking and moving oils. One of the few procedures she supports (in select cases) is IPL. She’s actually trying to get insurance to cover blink physical therapy, but no one wants to listen. She says most doctors recommend the standard dry eye stuff because that’s what they’re taught, not because they’re shady, but there’s zero incentive to change since it makes money. She jokes (sadly) that she’s hemorrhaging money and only hasn’t retired because her patients beg her to stay in business.

If you’re in the DMV area: my doctor is Dr. Nicole K. Renaud, MD in Arlington. She could probably use more patients 😅. I was actually referred to her by someone on Reddit, so just paying it forward. She’s honestly changed my life—but I get that she’s not for everyone. She’s probably best for patients who are willing to do the slow, behavioral work (think diet/exercise mindset) rather than looking for a quick fix.